376102651-5-30-2025-51-CC-GPOR-DH72BY-20250530171555

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376102651
Report Date: 05/30/2025
Date Signed: 05/30/2025 05:18:31 PM

Document Has Been Signed on 05/30/2025 05:18 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME:	YAROSHENKO, HALYNA FAMILY CHILD CARE		FACILITY NUMBER:	376102651
ADMINISTRATOR/ DIRECTOR:	HALYNA YAROSHENKO		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(858) 922-2631
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92128
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 11	CENSUS: 0	DATE:	05/30/2025
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	03:00 PM
MET WITH:	Halyna Yaroshenko		TIME VISIT/ INSPECTION COMPLETED:	05:45 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 5/30/25 at 3:00 pm, Licensing Program Analyst (LPA) Gerald Poindexter identified himself and disclosed the nature of the visit before being granted entry. LPA conducted an announced pre-licensing/change of Location inspection with the applicant Halyna YaraoshenKo. Also present at the home was the applicant’s adult son Serhii Yaroshenko. Applicant states they currently have 11 enrolled children. No daycare children were present during the inspection. Applicant states that hours of operation are Monday-Friday, 8 am to 5 pm. Fire clearance report was provided to the Department on 05/06/25. This visit is also to verify that the licensee remains in substantial compliance with the health & safety standards as required by regulations governing family childcare homes. The 3-bedroom, 3.5-bath, two-level home was toured and inspected to ensure an environment safe for the care and supervision of children. The applicant provided proof of control of property. Because the applicant rents/leases the home, proof of landlord notification is required. The LPA observed the Property Owner/Landlord Notification form (LIC9151) that the applicant confirms was provided to the property owner/landlord. The applicant has obtained a signed Property Owner/Landlord Consent form (LIC9149). Applicant states that they have sufficient financial resources to sustain the license. Applicant will use the following rooms for childcare: living room 1, living room 2 (next to kitchen), bathroom 1, and back patio. A portion of either living room 1 or 2 will be used to care for/separate sick children. Off-limits areas include: entire upstairs areas, the garage, and the hallway closet. These areas prevent access through use of lever locks and a safety gate for the stairs. Applicant has a fully fenced backyard patio available for outdoor activities. Applicant stated they understand that continuous visual supervision is required. There are no bodies of water in the home. CONT. ON PAGE 2

NAME OF LICENSING PROGRAM MANAGER: Joelle Redding
NAME OF LICENSING PROGRAM ANALYST: Gerald Poindexter
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/30/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: YAROSHENKO, HALYNA FAMILY CHILD CARE	FACILITY NUMBER: 376102651
	VISIT DATE: 05/30/2025

NARRATIVE

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There is a working phone at the facility. The fire extinguisher meets 2A10BC requirements. Carbon monoxide detector and smoke detector were tested and are operational. Poisons, cleaning compounds, medications and other hazardous items were latched/locked and secured out of reach of children. Heating and ventilation equipment were reviewed. Heating vents are toward the ceiling. Applicant states there are NO firearms and weapons in the home. The applicant has age-appropriate toys and equipment available.

Applicant’s Pediatric CPR and First Aid card expires 5/22/27. Preventative health practices course (with lead poison prevention training) completed. Applicant’s Mandated Reporter AB1207 training certification expires 8/15/26 and LPA reminded applicant that CPR/First Aid and Mandated Reporter training must be renewed every two years. Applicant’s helper Svetlana Panfilova’s Mandated Reporter certificate expires 10/18/26. Applicant’s helper Olena Rizakhanova’s Mandated Reporter certificate expires 10/17/26. Staff /resident immunization requirements were not met. Applicant’s helpers both need to provide proof of all required vaccines.

Applicant was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

LPA reviewed with the applicant:
· The LIC 311D, Forms/Records to Keep in Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to the applicant.
· Rules related to children’s personal rights, child abuse, and prohibiting of corporal punishment.
· Rules prohibiting smoking, walkers, exersaucers, jumpers and bouncy seats. Also, allowed/prohibited uses of car seats.
· Use of all equipment only as intended by the manufacturer.
· COVID-19 and other communicable diseases guidelines and resources
· Additional CDSS contact information and provider resources.

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NAME OF LICENSING PROGRAM MANAGER: Joelle Redding
NAME OF LICENSING PROGRAM ANALYST: Gerald Poindexter
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/30/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2025

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: YAROSHENKO, HALYNA FAMILY CHILD CARE	FACILITY NUMBER: 376102651
	VISIT DATE: 05/30/2025

NARRATIVE

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On this date, 5/30/25, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ. California Megan's Law and website: www.meganslaw.ca.gov

Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

LPA discussed the safe sleep regulations with the applicant and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep, as an additional resource. LPA also informed the applicant of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at: https://www.cpsc.gov/, and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication. CONTINUED ON PAGE 4

NAME OF LICENSING PROGRAM MANAGER: Joelle Redding
NAME OF LICENSING PROGRAM ANALYST: Gerald Poindexter
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/30/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2025

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: YAROSHENKO, HALYNA FAMILY CHILD CARE	FACILITY NUMBER: 376102651
	VISIT DATE: 05/30/2025

NARRATIVE

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The following corrections are needed prior to the issuance of the license:
· Applicant will provide copies of proof of required vaccines for two helpers, Svetlana Panfilova and Olena Rizakhanova
· Applicant will provide missing, required paperwork for all enrolled children

Once all corrections are made and proof is sent to, reviewed and approved by the Department, a license for 14 children may be granted upon the final file review. Applicant understands that proof of corrections must be submitted to Licensing within 30 days, by no later than 6/29/25, or the application may be denied. Applicant agreed to comply with all regulations and laws governing family child-care homes. Exit interview conducted and report was reviewed with the applicant Halyna Yaroshenko. Appeal rights provided.

NAME OF LICENSING PROGRAM MANAGER: Joelle Redding
NAME OF LICENSING PROGRAM ANALYST: Gerald Poindexter
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/30/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2025

LIC809 (FAS) - (06/04)

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